Vascular - Chapter 7 Multiple Choice

What is the secondary goal of examination of the extracranial carotid system by duplex ultrasound?

A. To identify patients at risk for stroke

B. To diagnose fibromusclar dysplasia

C. To document progression of disease

D. To screen for iatrogenic problems

C. To document progression of disease

Which transducer is most commonly used to perform a duplex evaluation of the extracranial cerebral vascular system?

A. 12-3 MHz linear array

B. 8-5 MHz curvilinear array

C. 4-1 MHz phased array

D. 5-3 MHz phased array

A. 12-3 MHz linear array

A patient presents to the vascular lab for a carotid vertebral duplex examination. Upon questioning, the patient reveals a 2-week history of intermittent blindness in the right eye. The symptoms resolve with a few seconds. What would these symptoms indicate?

A. CVA

B. RIND

C. TIA

D. DVT

C. TIA

How should the patients head be positioned in order to expedite a carotid-vertebral duplex examination?

A. head straight forward and elevated on a pillow

B. head rotated 45 degrees away from side being examined with a pillow under shoulders

C. head rotated 90 degrees toward side being examined supported by a pillow

D. head straight with a rolled up towel placed under the neck

B. head rotated 45 degrees away from side being examined with a pillow under shoulders

What is the most common technique used to identify the vertebral artery?

A. View the common carotid artery and angle the transducer slightly posteriorly

B. View the subclavian artery and angle the transducer superiorly

C. View the basilar artery and angle the transducer inferiorly

D. View the vertebral processes and angle the transducer medially

A. View the common carotid artery and angle the transducer slightly posteriorly

When qualifying the appearance of plaque by ultrasound, the use of which of the following terms is discouraged owing to poor reliability?

A. Homogenous/Heterogenous

B. Smooth/Irregular

C. Ulcerated

D. Calcified

C. Ulcerated

As plaque develops and fills the carotid bulb, what change be expected in the Doppler waveform at this level?

A. Extremely high velocities

B. Disappearance of normal flow separation

C. Helical flow around the plaque

D. Development of "steal" waveform

B. Disappearance of normal flow separation

Which of the following will NOT result in symmetrical (i.e., seen in both carotid and sometimes vertebral arterial systems) changes in the Doppler spectra?

A. Aortic valve or root stenosis

B. Brain Death

C. Subclavian Steal

D. Intra-Aortic balloon pump

C. Subclavian Steal

In a normally hemodynamically low-resistance system or vessel, such as the ICA and vertebral arteries, what will a change to high resistance pattern suggest?

A. Proximal stenosis or occlusion

B. Distal stenosis or occlusion

C. Steal Syndrome

D. Normal change bc exercise

B. Distal stenosis or occlusion

What is a reactive hyperemia, a provocative maneuver used during the duplex evaluation of the extracranial cerebrovascular system, used to demonstrate?

A. The diagnosis of brain death

B. A change from latent or partial to complete subclavian steal

C. The existence of a unilateral congenital small vertebral artery

D. The effect of an intra-aortic balloon pump

B. A change from latent or partial to complete subclavian steal

Which of the following is NOT "sound" advice for sonographers who wish to prevent repetitive stress injuries while scanning?

A. Be ambidextrous

B. Arrange bed and equipment to be close to patient

C. Remain well hydrated during the day

D. Avoid doing stretching exercises

D. Avoid doing stretching exercises

Which of the following is NOT a characteristic of normal Doppler waveform contour?

A. Brisk systolic acceleration

B. Sharp systolic peak

C. Increased spectral broadening

D. Clear spectral window

C. Increased spectral broadening

Why do Doppler waveforms in the CCA's display a contour suggestive of relatively low-resistance.

A. 70% of its flow supplies the ICA

B. 90% of its flow supplies the ICA

C. 70% of its flow supplies the ECA

D. 90% of its flow supplies the ECA

A. 70% of its flow supplies the ICA

What type of flow is characterized by a blunted, resistive waveform that often occurs as disease progresses to near occlusion?

A. Steak flow

B. Tardus Parvus Flow

C. Bidirectional Flow

D. String Sign Flow

D. String Sign Flow

Which statement on power Doppler is FALSE?

A. It represents the amplitude of the Doppler signal instead of the frequency shift

B. It depends on the angle of insonation

C. It does not give information about flow direction

D. It can detect low flow states

B. It depends on the angle of insonation

A patient presents to the vascular lab with a severe distal CCA obstruction; however, the ICA and ECA remain patent. What is the lesion typically called?

A. Subclavian steal syndrome

B. String sign lesion

C. Choke lesion

D. Tardus Parvus Lesion

C. Choke lesion

During duplex evaluation of the ICA, peak systolic velocities are noted to be 532 cm/s and end diastolic velocities are 167 cm/s. According to the University of Washington criteria, into what stenosis category would these findings fall?

A. 16% to 49% stenosis

B. 50% to 79% stenosis

C. 80% to 99% stenosis

D. Occlusion

C. 80% to 99% stenosis

For subclavian steal syndrome or phenomenon to occur, where does a severe stenosis or an occlusion need to be present?

A. The subclavian artery distal to the vertebral artery

B. The left subclavian artery it brachiocephalic artery proximal to the vertebral artery origin

C. The origin of CCA's

D. Anywhere in the brachial arteries

B. The left subclavian artery it brachiocephalic artery proximal to the vertebral artery origin

Which of the following would affect pulsed Doppler spectrum contour in all vessels of the extracranial cerebrovascular arterial system even when no disease is present?

A. Low cardiac output

B. Aortic Root Stenosis

C. Intra-Aortic ballon pump

D. All of the Above

D. All of the Above

During duplex evaluation of the carotid artery system, velocities in the external carotid artery reached 250 cm/s, the turbulence was noted just after the area of increased velocity. What do these findings suggest?

A. > 50% stenosis

B. Normal findings for the ECA

C. 50% to 79% stenosis

D. >80% stenosis

A. > 50% stenosis